Means for treating clubfoot



Nov. 5, 1963 p. R. BRACHMAN 3,109,424

' MEANS FOR TREATING CLUBFOOT Filed May 19. 1961 INVENTOR. PmuP R.BRAQHMAN REL-i 5- United States Patent 3,1fi9,424 MEANS FOR TREATINGCLUBFOOT Philip R. Brachrnan, 25 E. Washington St, Chicago 2, Ill. FiledMay 19, 1%1, Ser. No. 111,263 5 Claims. (Cl. 128-30) This inventionrelates generally to corrective apparatus for the treatment of talipesor clubfoot and more particularly relates to improved apparatus of thetype disclosed in U.S. Patent No. 2,482,646, and of which I was one ofthe co-inventors.

Talipes, the deformity commonly known as clubfoot, can assume a varietyof forms such as, for example, talipes varus wherein the afllicted footis bent inward, or talipes valgus wherein the foot is bent abnormallyoutward. As described in the aforementioned patent, previous treatmentof such deformed feet, particularly among children, generally involvedsome preliminary corrective manipulation after which an uncomfortableand somewhat immobilizing cast or splint was applied. The purpose of thecast or splint was to retain the afflicted foot in the improved positionand prevent the same from returning back to the original deformedposition. The many disadvantages inherent in the described prior methodof treatment were of course apparent, and there thus existed a greatneed for a new and better method of treating such afilictions.

The apparatus of the aforementioned patent most admirably filled thedescribed need by affording a new and most elficient method for thetreatment of clubfoot. In general, that apparatus comprised a pair ofshoes having means for interconnecting the same in fixed spaced 'apartrelationship and pivotal means which prevented the foot from movingbeyond the improved position toward the original deformed position whileat the same time permitting movement of the foot within substantiallythe normal range of movement in a direction from the-improved positionopposite that of the deformed position. 'I'hus correction was appliedwhile at the same time permitting therapeutic exercise and a certaindegree of walking freedom.

Although the patented apparatus unquestionably represented a mostsignificant advancement of the art, it has been found, through continuedexperimentation and use thereof, that the same contained certaindisadvantageous features. It may be remembered that in the patentedapparatus the attachment for each shoe included a pair of metal plateshaving the same configuration 'as the shoe sole and a pair of spacerblocks positioned therebetween. A pair of metal bars were employed topivotallyand adjustably interconnect the two shoes. Numerous threadedpositioning holes Were drilled in the metal plates shoes was a timeconsuming task necessitating the use of a substantial number of screws,bolts, or the like. In addition, the apparatus was unduly cumbersome,excessive in weight and expensive to manufacture.

It is therefore an important object of this invention to provideimproved apparatus of the character described which overcomes all of theaforementioned disadvantages while at the same time retaining all of thebeneficial results of the patented apparatus.

Another object is to afford improved apparatus of the characterdescribed which is extremely light in weight.

In this regard, the invention employs only one interconnecting bar andeliminates entirely the metal plates of the patented apparatus.

3,16%,424 Patented Nov. 5, 1963 "ice A further object is to provideimproved apparatus of the character described having simple-to-operatemeans for readily adjusting the prescription angle, i.e., the anglesdefined by the longitudinal axes or center lines of the feet of a userin a prescribed improved position and from which neither foot alone ismovable toward its deformed position. Thus, the apparatus may be readilyprogressively adjusted as the correction of the deformity is increased.A related object is to provide such apparatus wherein the prescriptionangle is readily variable to adapt the apparatus for treatment oft-alipes of the type wherein the forward ends of the feet are turnedoutwardly relative to each other (vmgus), and of the type wherein theyare turn-ed inwardly toward converging relationship (v arus).

Still another object is to afford improved apparatus of the characterdescribed which may be simply and quickly attached to the shoes and inwhich many of the parts heretofore required for this task have beeneliminated.

Still a further object is to provide improved apparatus of the characterdescribed which, while preventing movement of a deformed foot betweenthe improved position and the deformed position, permits exercising thefoot and leg by movements thereof outside the range between the deformedand improved positions.

Yet another object is to afford improved apparatus of the characterdescribed which enables an afllicted user to move the feet to and frorelative to each other in a manner simulating walking. 1

Yet a further object is to provide improved apparat of the characterdescribed which may be inexpensively fabricated and yet is mostefficient for the purposes intended.

.With the foregoing and other objects in View which will appear as thedescription proceeds, theinvention consists of certain novel features ofconstruction, arrangement and a combination of parts hereinafter fullydescribed, illustrated in the accompanying drawings, and particularlypointed out in the appended claims, it being understood that variouschanges in the form, proportion, size and minor details of the structuremay be made without departing from the spirit or sacrificing anyof theadvantages of the invention.

For the purpose of facilitating an understanding of my invention, I haveillustrated in the accompanying drawings a preferred embodiment thereof,from an inspection of which, when considered in connection with thefollowing description, my invention, its modeof construction, assemblyand operation, and many of its advantages should be readily understoodand appreciated.

Referring to the drawings in which the same characters of reference areemployed to indicate corresponding or similar parts throughout theseveral figures of the drawing: 1

FIG. 1 is front elevational view of apparatus for the treatment oftalipes embodying the principles of the invention; 1

FIG. 2 is a bottom plan view with portions broken away of otherwiseremoved to facilitate illustration and showing prescription angle forthe type of deformity wherein the heel-to-toe-axes or center lines ofthe deformed feet converge, and showing also, in dotted outline, therelative displacement of one of the shoes about an axis at the othershoe;

FIG. 3 is a similar view with portions removed and showing the shoes ina position within the normal range of their indepedent pivotal motionaway from the deformed position;

FIG. 4 is an enlarged and invertedsec-tional view taken on the plane ofline 4- -4 in FIG. 3 and viewed in the direction indicated;

FIG. 5 is a sectional view taken on the plane of line -5 in FIG. 4 andviewed in the direction indicated;

. and

14 of ordinary construction, each of said shoes having a V sole 16, aheel 18 and a lace 20 or other suitable means for holding the shoe onthe foot of a wearer thereof.

The shoes 12 and 14 are pivotally connected together by novel connectingmeans which are indicated generally by the numeral 22. The connectingmeans 22 comprises a pair of identical heel assemblies 24, each of whichis connected to the heel 18 of a shoe 12 or 14. Turning to FIG. 4 of thedrawings, it will be seen that the heel assembly 24 comprises anindexing plate 26 having a plurality of indexing holes 28 formed thereinand positioned in radially spaced relationship as indicated in FIG. 5.Connected to the indexing plate 26 is an internally threaded central hub30. The hub 30 terminates in a reduced diameter portion 32 therebyaffording a shoulder 34. The indexing plate is preferably integrallymade from a rigid metal or the like, and the same may be mounted on theheel 18 by any suitable means such as the screws 36. V

V Cooperating with the indexing plate 26 is a centrally aperturedlocking plate 38. Integrally formed, or otherwise connected to thelocking plate 38 is an outwardly projecting locking pin 40, said lockingpin being adapted to fit into any of the indexing holes 28. It will thusbe noted that when the locking plate 38 is positioned on the hub 30 thesame rests on the shoulder 34 thereof with the locking pin 40 beingreceived in one of the indexing holes 28. A locking screw 42 isthreadedly received within the hub 30 for locking the two plates 26 and38 in any desired positioning relationship for purposes which willsubsequently be more fully described. A suitable washer such as 44 maylikewise be employed for facilitating the unscrewing of the lockingscrew 42 when desired.

Connecting the two heel assemblies 24 is a rigid connecting bar 46. Theconnecting bar 46 is provided with an opening adjacent each end thereofof sufiicient dimension to freely accommodate the hub 30 therethrough.

. When operationally assembled, the connecting bar 46 is positionedbetween the plates 26 and 38 at each. end

thereof as indicated in FIG. 4. It is important to note, however, thatthe shoulder 34 of the hub 30* prevents the locking plate 38 fromimpinging upon the end of the connecting bar 46 so that the latter isthus free to rotate about each of the hubs 30.

A protective disc 48 of neolite, leather, or the like, is

glued or otherwise suitably connected to the locking plate 38 forpurposes of shielding the head of the locking screw 42. The protectivedisc 48 is provided with a central aperture 50 so that free access maybe had to the screw 42- which is countersunk in said aperture. Whenrequired for purposes of better balance, a toe piece such as 52 may beglued or otherwise suitably connected to the Solo 16 of the shoe asindicated in FIGS. 1, 2 and 3. The toe piece 52 may likewise be made ofneolite, leather, or the like.

The operation of the apparatus 10 may now be described with particularreference being had to FIGS. 2 and 3 of the drawings wherein it will benoted that the apparatus has. been adjustably set to provide a desiredprescription angle for the treatment of an in-toeing or talipes varuscondition. 'It will thus be noted that the locking pin 40 is positionedanteriorly of the connecting bar 46 so that any further motion of theshoes 12 and 14 toward each other is thereby effectively prevented. Inother words, the position shown in FIG. 2 is the improved prescriptionposition beyond which the shoes cannot be moved back toward the originaldeformed position. However, as seen in FIG. 3, the shoes are nonethelessfree to rotate within any normal range of movement in a directionopposite from the deformed position. Similarly, the free notatability ofthe connecting bar 46 about either of the hubs 30 permits the patient tomove either leg forwardly or rearwardly in a walking motion as indicatedby the dotted line showing.

For purposes of treating an out-toeing or talipes valgus deformity, itis simply necessary to adjust the relative position of the locking pin40 so that the same is positioned posteriorly of the connecting bar 45.Such adjustment may be readily accomplished by loosening the lockingscrew 42. The locking plate 38 may then be raised s-ufliciently topermit rotation of the same until the locking pin 40 is positioned inthe proper indexing hole 28 to afford the desired prescription angle.The operation of the apparatus in treating an out-toeing condition is ofcourse the same except that in this case, outward movement of the feetis limited by the locking pin 40 whereas inward movement of the feettowardeach other is unlimited. 7 v

In order to provide the greatest degree of adjustability of theprescription angle, the indexing plate 26 should be formed with as manyradially spaced indexing holes 28 as is practicable. Thus, in theembodiment illustrated, there are 20 such indexing holes in each of theindexing plates. It will thus be appreciated that the positioning of thelocking pin 49 in each adjacent indexing hole 28 provides a change inthe prescription angle of approximately 18.

From the foregoing description and drawings, it should be apparentwithout further description that I have provided a novel and mostefficient improved apparatus for treating clubfoot. The apparatus islight in weight and may be quickly and simply adjusted'to treat bothtypes of talipes or to vary the prescription angle as desired. In thisregard, while the connecting bar 46 is preferably made of a rigid metal,the same may nonetheless be bent slightly to effect inversion oreversion, if desired; In addition, the connecting means of the apparatusmay be inexpensively manufactured, has a greatly reduced number of.

be readily understood from the foregoing without further description,and it should also be manifest that while a preferred embodiment of theinvention has been shown and described for illustrative purposes, thestructural detailsare nevertheless capable of wide variation within thepurview of my invention as defined in the appended claims.

What I claim and desire to secure by Letters Patent of the United Statesis:

1. In apparatus of the class described, a pair of shoes, a pivot. pointdepending from the heel of each of said shoes, means pivotally connectedto said pivot points, said means spacing said shoes apart and meansunder the heels of said shoes for adjustably limiting the pivotalmovement of each of said shoes in one direction and permitting ing meansfor varying the relative position of said locking means, said indexingmeans comprising an indexing plate secured to said shoe heel, saidindexing plate being formed with a plurality of indexing holes spacedradially around the circumference thereof, and a central hub de pendingfrom said indexing plate to afford said pivot pornt, said locking meanscomprising a locking plate r0- tatably mounted on the free endof saidhub, said spacing bar positioned between said locking plate and saidindexing plate, and a locking pin projecting upwardly from said lockingplate and positionable in any of said indexing holes for limiting thepivotal movement of said spacing bar about said hub.

2. In apparatus of the class described, the combination with a pair ofshoes, of a heel assembly secured to the bottom of the heel of each ofsaid shoes, said heel assemly comprising pivot means, locking means andindexing means for adjustably positioning said locking means, and arigid spacing bar pivotally connected at each end thereof to said pivotmeans, said locking means cooperating with said spacing bar for limitingthe pivotal movement in one direction only of each of said shoes aboutsaid pivot means, said heel assembly comprising an indexing platesecured to said heel and a central hub depending from said indexingplate to afford said pivot means, said spacing bar having an opening ateach end thereof whereby the same is pivotally mounted over said hub,said indexing means comprising a plurality of indexing holes formed insaid indexing plate, said indexing holes being radially spaced toprovide a circle having said hub as the center thereof, in which saidlocking means comprising a locking plate rotatably mounted on the freeend of said hub, said spacing bar being positioned between said indexingplate and locking plate, and a locking pin projecting upwardly from saidlocking plate, said locking pin being positionable in any of saidindexing holes and cooperating with said spacing bar to limit saidpivotal movement of said shoes.

3. The apparatus of claim 2 in which a toe piece is secured to the soleof each of said shoes.

4. Apparatus for the treatment of clubfoot comprising a pair of shoes, acircular indexing plate secured to the heel of each of said shoes, saidcircular plate being formed with a plurality of radially spaced indexingholes, a central internally threaded hub integrally formed with anddepending from said indexing plate, said hub including a reduceddiameter portion alfording an annular shoulder, an elongated rigidspacing bar having an opening adjacent each end thereof pivotallyconnected to said hubs, a centrally apertured cooperating locking platerotatably mounted on said reduced diameter portion so that the samerests on said annular shoulder, said spacing bar being retained betweensaid indexing plate and said locking plate a locking pin integrallyformed with and projecting upwardly from said locking plate, saidlocking pin being positionable in any of said indexing holes, and alocking screw threadedly received in said hub for looking said lockingplate in any selected relative position with said locking pin positionedin any selected one of said indexing holes.

5. The apparatus of claim 4 in which a centrally apertured circularprotective disc is secured to the outer surface of said locking plate.

References Cited in the file of this patent UNITED STATES PATENTS156,200 Autenrieth Oct. 27, 1874 2,482,646 Brachman et al. Sept. 20,1949 2,630,801 Mest et al Mar. 10, 1953 2,702,542 Gessel Feb. 22, 19552,963,020 Moran Dec. 6, 1960 OTHER REFERENCES The Journal of Bone andJoint Surgery for October 1944, p. 790, 1947 catalog of the Zimmer Mfg.Co., p. 114 (copies of the above in Division 55).

1. IN APPARATUS OF THE CLASS DESCRIBED, A PAIR OF SHOES, A PIVOT POINTDEPENDING FROM THE HEEL OF EACH OF SAID SHOES, MEANS PIVOTALLY CONNECTEDTO SAID PIVOT POINTS, SAID MEANS SPACING SAID SHOES APART AND MEANSUNDER THE HEELS OF SAID SHOES FOR ADJUSTABLY LIMITING THE PIVOTALMOVEMENT OF EACH OF SAID SHOES IN ONE DIRECTION AND PERMITTING THEPIVOTAL MOVEMENT OF SAID SHOES IN THE OPPOSITE DIRECTION, SAID FIRSTMENTIONED MEANS COMPRISING A RIGID SPACING BAR HAVING AN OPENING ATEITHER END THEREOF FOR ACCOMMODATING SAID PIVOT POINTS THERETHROUGH,SAID LAST MENTIONED MEANS COMPRISING A HEEL ASSEMBLY SECURED TO THE HEELOF EACH OF SAID SHOES, SAID HEEL ASSEMBLY COMPRISING A PIVOT POINT,LOCKING MEANS COOPERATIVE WITH SAID SPACING BAR FOR LIMITING SAIDPIVOTAL MOVEMENT AND INDEXING MEANS FOR VARYING THE RELATIVE POSITION OFSAID LOCKING